Evidence-Based Practice in the Field of Nutrition: A Systematic Review of Knowledge, Skills, Attitudes, Behaviors and Teaching Strategies

OBJECTIVES: Evidence-based practice (EBP) has been embraced and supported in medicine and several allied health professions for over a decade. We conducted a comprehensive review of the literature to explore EBP competencies and teaching strategies within the nutrition field. METHODS: Five databases (MEDLINE, EMBASE, ERIC, Cochrane, CINAHL) were systematically searched for observational and experimental studies from inception to August 2021. Eligible studies had to document EBP competencies or teaching strategies to improve EBP competencies among nutrition students and professionals. Competencies were categorized as: i) framing answerable questions, ii) searching literature for best evidence, iii) assessing study quality and/or risk of bias (RoB), iv) interpreting the importance of results, v) interpreting certainty of evidence, vi) applying results based on client values and preferences, vii) evaluating clinical performance. Currently, two reviewers are independently screening, abstracting data, and assessing RoB. RESULTS: We screened 1006 initial articles to find 9 eligible studies. Six cross-sectional surveys discussed EBP competencies among registered dietitians (RD) and dietetic interns, while 1 randomized trial and 2 before and after studies evaluated the effectiveness of teaching strategies among RDs and undergraduate students. Studies assessed 2 to 5 EBP competencies using heterogeneous methods that were often unclear. Participants generally scored low with respect to knowledge and skills across the competencies assessed. For instance, the largest study, a survey of RDs from the American Dietetic Association reported that among 258 participants, 64% never attended an EBP lecture, 45% never received formal training in RoB, and 31% did not understand 95% Confidence Intervals. Among teaching strategies, journal clubs improved EBP competencies the most, including framing answerable questions, searching literature, assessing RoB, and applying study results. Full results forthcoming. CONCLUSIONS: Preliminary results indicate that few nutrition students or professionals have adequate EBP competencies, including skills in RoB assessment and interpreting the importance of study results. Regular journal clubs are an effective way to teach most competencies in EBP. FUNDING SOURCES: Texas A&M Presidential Transformational Teaching Grant.